Customized composite reconstruction of extensive midfacial defects

Kevin Keller, Henry C. Vásconez

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


We describe the treatment of 2 patients with extensive midfacial defects by using a customized composite flap. Autogenous bone was transferred from the lilac crest, revascularized by the rectus muscle, and then transferred as a complete unit by microvascular technique to provide a vascularized bone graft to this area of difficult reconstruction. The bone was shaped and customized to fit the osseous defect. Although the rectus muscle was relatively bulky at the time of harvest, its hearty blood supply permitted trimming and contouring to fit the gap. This technique was based on the principles proposed previously by other authors regarding the vascularization of a free bone graft and its transfer as a composite flap. This technique requires more research and refinement, however this clinical demonstration shows the feasibility of revascularizing a composite flap and the extent to which this technique can be performed.

Original languageEnglish
Pages (from-to)291-296
Number of pages6
JournalAnnals of Plastic Surgery
Issue number3
StatePublished - 1998

ASJC Scopus subject areas

  • Surgery


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